Accelerated Community Oncology Research Network, 1770 Kirby Parkway, Suite 400, Memphis, TN 38138, USA.
J Clin Sleep Med. 2009 Apr 15;5(2):132-6.
To evaluate the relation among several symptoms that occur commonly in cancer patients: trouble sleeping, fatigue/sleepiness, depressed mood, and pain in a large cohort of cancer patients undergoing treatment in a community oncology practice.
Demographic, clinical, and patient reported outcomes data from 11,445 cancer patients undergoing treatment in a large community oncology practice were analyzed using structural equation modeling. The data were split so that a model was constructed using half of the patients; this model was then cross-validated on the remaining patients.
Fatigue was best represented as a latent variable, and significant direct effects were found for trouble sleeping, depressed mood, and pain. Also, there were significant indirect effects of these variables on fatigue. The effect of depressed mood on fatigue and pain was mediated by trouble sleeping, and the effect of trouble sleeping on fatigue was mediated by pain.
These results predict that interventions aimed at treatment of trouble sleeping, depressed mood, and pain will improve fatigue in patients with cancer. Further, these data predict that treatment of trouble sleeping will improve pain management in this population.
在一个社区肿瘤学实践中接受治疗的大量癌症患者中，评估几种常见癌症患者症状之间的关系：睡眠困难、疲劳/嗜睡、抑郁情绪和疼痛。
使用结构方程模型分析了 11445 名在大型社区肿瘤学实践中接受治疗的癌症患者的人口统计学、临床和患者报告的结果数据。将数据分为两部分，使用一半患者构建模型，然后在其余患者中进行交叉验证。
疲劳最好表示为一个潜在变量，并且发现睡眠困难、抑郁情绪和疼痛对疲劳有显著的直接影响。此外，这些变量对疲劳有显著的间接影响。抑郁情绪对疲劳和疼痛的影响是通过睡眠困难介导的，而睡眠困难对疲劳的影响是通过疼痛介导的。
这些结果表明，针对治疗睡眠困难、抑郁情绪和疼痛的干预措施将改善癌症患者的疲劳状况。此外，这些数据预测，治疗睡眠困难将改善该人群的疼痛管理。
